| NPI | 1922537067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDDIQUI HERNANDEZ Owner 443-741-8920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD R205786) |
| Enumeration Date | 2017-06-11 |
| Last Update Date | 2022-07-21 |