| NPI | 1477199875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORTHWEST REGISTERED AGENT SERVICES Registered Agent 443-416-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-06-24 |