| NPI | 1205213436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DOYLE Bureau Chief, Laa 410-876-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD LP19143) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: MD LP19143) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2015-04-27 |