| NPI | 1467823773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEO LAVERNE EDMONDS Project Director 443-884-7642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2022-07-21 |