| NPI | 1659883007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIVON MASSENBURG Executive Officer/Counselor 443-351-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |