| NPI | 1578995213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA FONTAINE Qa 410-277-8910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |