| NPI | 1841647617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK J HUDAK CEO 410-576-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD MH-1881) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2016-05-20 |