| NPI | 1639536527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE LOUIS FIELDING Program Director 443-957-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 1623) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |