| NPI | 1801056098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN HERRON Executive Director 410-227-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD MH-1146.) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2023-03-27 |