| NPI | 1417768912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SIMKIN-BROCATO Compliance Officer 443-517-8724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |