| NPI | 1467817049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARVIN BROWN President/Owner 667-303-3314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LCA1636) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |