| NPI | 1164240933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MARLENE COOK Owner 443-881-3746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-11-07 |