| NPI | 1912401183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEADRA M MARTIN Owner/Program Coordinator 443-500-4887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2020-06-10 |