| NPI | 1700359254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KSISHA STEVENSON-JOHNSON Program Director 410-585-4728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |