| NPI | 1285274274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMEL JOHNSON-SMITH Owner 443-787-2894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |