| NPI | 1518510692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVIKUMAR BHALAVAT Medical Director 410-670-3076 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |