| NPI | 1265070692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MORRILL Executive Director 443-442-1568 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |