| NPI | 1649894254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHIMA THOMAS Clinical Director 443-219-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-05-31 |
| Last Update Date | 2020-12-20 |