| NPI | 1639911100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY ANN SHAW-WILSON Quality Assurance & Compliance Spec 443-986-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-06-06 |