| NPI | 1932055506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIERRA BURLEY Credentialing Specialist 410-732-0983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-03-06 |
| Last Update Date | 2026-03-06 |