| NPI | 1235091497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADE WILFRED MARCUS Director 443-629-9243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261Q00000X Clinic/Center | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2025-11-25 |
| Last Update Date | 2025-11-25 |