| NPI | 1710644760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEHINDE OLAMOYEGUN CEO 410-505-0419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2021-11-24 |