| NPI | 1457112047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ROSS Nurse Practitioner 410-971-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-04-27 |