| NPI | 1255926564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUWAFEMI SHODIPE Administrator 443-348-3981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| 363LC1500X Nurse Practitioner Community Health | |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-03-08 |