NPI | 1326633595 |
---|---|
Entity Type | Organization |
Authorized Contact | MARSHALL MIDDLE NAME JAMES CEO 443-519-6409 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-03-09 |
Last Update Date | 2023-11-14 |