| NPI | 1811705957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XANDER D FAISON Director 443-991-1582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-12-20 |
| Last Update Date | 2024-12-20 |