| NPI | 1942735022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI FIELDS Office Manager 443-559-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |