| NPI | 1457984700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAELENE MENESES Compliance And Credentialing Coordi 410-444-3804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| 252Y00000X Early Intervention Provider Agency | |
| 261QA3000X Clinic/Center, Augmentative Communication | |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-03-27 |