| NPI | 1699150144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRILL WAIZETTE BRYANT BASS Executive Director 443-463-9523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |