| NPI | 1518557529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE IWEBO Provider 410-900-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2025-01-30 |