| NPI | 1528736386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA SURIN Owner 410-989-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-09-05 |
| Last Update Date | 2021-09-05 |