| NPI | 1720641509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA OHIKU Director 410-404-7651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2020-05-06 |