| NPI | 1932085149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVRON SHAKIR KEENE CEO 410-705-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 225X00000X Occupational Therapist | |
| 103K00000X Behavior Analyst | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 103T00000X Psychologist | |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-10-15 |