| NPI | 1255861225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SHANK It Manager 410-996-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 1989) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-06-13 |