| NPI | 1316893613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOREY SHORB Director 443-920-4744 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-03-09 |
| Last Update Date | 2026-03-09 |