| NPI | 1508297292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANIKA LA'TIA BURKE COO 443-977-8879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2026-03-06 |