| NPI | 1336808914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OBI HERBERTS Credentialing Specialist 410-213-5494 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2024-10-23 |