| NPI | 1477333615 |
|---|---|
| Other Name | SELF EMPLOYED |
| Entity Type | Organization |
| Authorized Contact | DONNELL WRIGHT CEO 443-983-4520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-04 |