| NPI | 1811452279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY SINCLAIR GROVE Owner 410-908-9820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-02-09 |
| Last Update Date | 2022-09-19 |