| NPI | 1376997544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE WILLOUGHBY Qa Director 410-353-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 100725) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |