| NPI | 1437640729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORLETT WHITEHEAD Chief Clinical Officer 443-636-7978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 13404) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD 13404) |
| 101YM0800X Counselor Mental Health (Licence: DC LC302189) | |
| 1041C0700X Social Worker Clinical (Licence: DC LC302189) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: MD 13404) | |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: MD 13404) | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2019-12-20 |