NPI | 1831761121 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY RENNA THOMAS Credentialing Specialist 410-663-4036 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-07-15 |
Last Update Date | 2021-07-28 |