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 |