| NPI | 1538552641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA CISNEROS Business Manager 410-741-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LC6090) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |