| NPI | 1548709744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA THOMAS Program Director 410-370-8544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD AC1434) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |