| NPI | 1871284463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUTRESA LANKFORD - PURNELL Owner 410-202-6716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-05-16 |