| NPI | 1417673245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JEREL WILSON CEO 443-814-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-13 |