| NPI | 1811718307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIVON MASSENBURG President 443-351-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-10-18 |