| NPI | 1821700816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIARA JACKSON Clinical Director 443-509-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2022-12-21 |