| NPI | 1326530304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFINI DAVIS Owner 443-889-5265 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-01-03 |