| NPI | 1194524843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHA'LLAH SABRIYYAH BREWTON Principal 410-621-9337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-17 |