NPI | 1598025835 |
---|---|
Entity Type | Organization |
Authorized Contact | DANTE WILSON Chief Executive Officer 443-226-6866 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: MD MH-1074) |
Additional Taxonomies | 251S00000X (Licence: MD MH-1875) |
Enumeration Date | 2012-05-21 |
Last Update Date | 2017-04-27 |