| NPI | 1790484236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTLE BROWN Billing Manager 410-870-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |