| NPI | 1750856191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LYNN WARD Fiscal Chief 410-876-4977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-10-12 |