| NPI | 1902175128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LAURESKA Deputy Health Officer/Operations 410-222-7377 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD 904875) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2014-12-11 |