| NPI | 1174230882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACY DENISE ALLEN CEO 443-707-8319 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |