| NPI | 1912553009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNNA THOMAS CEO 443-402-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |