| NPI | 1265446496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER LISTER GEAR Executive Director 410-876-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-09-11 |