| NPI | 1174327027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITEARA MICKEY Executive Director 443-447-1917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QA0600X Clinic/Center Adult Day Care | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2025-04-01 |
| Last Update Date | 2025-04-01 |