| NPI | 1891033916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DURWOOD WHITTEN Sole Proprietor 443-438-7863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 04983) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |