| NPI | 1881215101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETTY NGONA Program Director 443-465-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |