| NPI | 1295144319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE WILLOUGHBY Qa Manager 410-353-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD MH1493) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-05 |