| NPI | 1417192584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L COOPER CFO 410-778-9114 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: DE 106301) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |