| NPI | 1659316636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MATRICARDI State Director 443-543-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MD 2012) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-08-22 |