NPI | 1619758216 |
---|---|
Entity Type | Organization |
Authorized Contact | SHIRLEY SUTTON President/CEO 410-558-4891 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
Enumeration Date | 2023-10-10 |
Last Update Date | 2024-02-02 |