| NPI | 1760610596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE FIELDING Program Director 410-780-2692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2016-08-18 |