| NPI | 1912580218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDMUNDS Chief Financial Office/Owner 410-372-7628 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-09-30 |