| NPI | 1942660717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE LOUIS FIELDING Program Director 443-957-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 1793) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |