| NPI | 1649865437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARITA HINTON Provider 443-720-0806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2021-03-04 |