| NPI | 1205081965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L FORYS Owner 410-271-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD 04289) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2008-11-22 |