| NPI | 1467973149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HEARD Program Director 443-904-8831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MD 161287) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-07-21 |