| NPI | 1275956377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN N HERRON Clinical Director 410-227-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2019-07-08 |