| NPI | 1164923439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNNA THOMAS Owner 443-402-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD BH000296) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: MD BH000296) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2019-07-24 |