| NPI | 1285124339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAG NELLURI President & CEO 443-995-4113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD MH-1846) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD MH-1962) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 905861) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-06-16 |