| NPI | 1861620239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS PATRICK BENNER Executive Director 410-964-2771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 101YA0400X) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MD LCA157) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |