| NPI | 1801306030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER RILEY Owner 443-310-8753 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD MH2356) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-01-24 |