| NPI | 1215552062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FULAI DIOM COO 443-213-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| 106S00000X Behavior Technician | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2025-06-24 |