| NPI | 1942243696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA S CASSATT CEO 410-467-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-12-12 |