| NPI | 1679073498 |
|---|---|
| Other Name | ITHC, CO |
| Entity Type | Organization |
| Authorized Contact | DERMELL BRUNSON President 410-961-6256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-08-17 |