| NPI | 1174084107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA FAITH NOPPENBERGER Owner 443-621-8722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2019-04-28 |