| NPI | 1235888157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD EUGENE DEGRAFENREID Owner 443-708-8139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-03-18 |