| NPI | 1366999310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN CLENDANIEL Billing Manager 410-810-2465 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DE 1990037507) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2017-05-02 |