| NPI | 1417673062 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | CATHERINE KOSKEI C RN P/Pmh 443-813-4272 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |