| NPI | 1578264636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER RADISH Office Manager/Billing 443-859-8584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-03-15 |