| NPI | 1720797582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGUFOR FUBE DIVINE President 410-870-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2024-11-26 |