| NPI | 1962601468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CASSANDRA CHANCE Owner 410-837-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD 16952) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |