| NPI | 1629396809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA THOMPSON President / Care Manager 410-841-4196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD 152825) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |