| NPI | 1851020861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARIE SINGLETON Program Administrator 410-320-9967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |