| NPI | 1689022790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DIGGS Owner 410-698-8442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD LGP6393) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-06-17 |