| NPI | 1760342075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE DOYLE Owner 443-917-1977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2025-11-18 |
| Last Update Date | 2025-11-18 |