| NPI | 1285321638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON T DAVIS Owner 410-413-4108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261Q00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |