| NPI | 1376701193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH AUGUSTSON Owner 410-705-1331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MD LC-2284) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: MD NCC-93405) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2024-05-03 |