| NPI | 1194356212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L GREEN Fiscal Supervisor 410-996-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-10-13 |