| NPI | 1528496650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA ROZENBERG Owner 443-621-1384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD R143360) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2014-06-02 |