| NPI | 1285121897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE TALLEY Administrator 410-736-9918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 21023) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |