| NPI | 1306385232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY FORKA President 443-526-6133 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MD R219171) |
| 251V00000X Voluntary or Charitable (Licence: MD R219171) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2020-05-04 |