NPI | 1508571670 |
---|---|
Entity Type | Organization |
Authorized Contact | IESHA KENYETTE FELTON Owner 443-707-5891 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 251S00000X |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2023-01-23 |
Last Update Date | 2023-01-23 |