| NPI | 1457839284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DUKES Program Owner 443-831-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD BH001052) |
| Additional Taxonomies | 251S00000X (Licence: MD BH001052) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD BH001052) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: MD BH001052) | |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2023-09-18 |