| NPI | 1871315200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDAAT TIMBO-JALLOH Nurse Practitioner 410-446-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |