| NPI | 1790542595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN SHEM ANYONA Owner 443-985-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-02-28 |