| NPI | 1508386079 |
|---|---|
| Other Name | WILDE LAKE HIGH SCHOOL-BASED WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | CARLETTA LYNN MCKNIGHT Fiscal Account Manager 410-313-6300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2023-05-19 |