| NPI | 1366727034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J LANE President 443-280-2916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 04531) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2011-10-13 |