| NPI | 1164455440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD B HACKETT Executive Director 410-341-4472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MD DDA1052304) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MD 2293615) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |