| NPI | 1669941175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CORY SHAFFER Care COO Rdinator 443-559-4137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2024-06-24 |