| NPI | 1518399187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY NWOGWUGWU Director 443-722-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 4438) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2024-01-25 |