| NPI | 1487702098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF RICHARDSON CEO 410-453-9553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |