| NPI | 1861733354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE CAMPBELL COX Program Director 443-629-8388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2023-07-26 |