| NPI | 1184093221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL COURTNEY MATYJA Owner/Resident Agent 443-927-6535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD LC6058) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2020-10-24 |