| NPI | 1184290868 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | RANDALL COOPER Chief Financial Officer 410-810-2468  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling | 
| 104100000X Social Worker | |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2021-06-02 | 
| Last Update Date | 2021-06-10 |