| NPI | 1316350572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIA LOREN CHARLES Director 410-908-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 1421) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |