| NPI | 1972597425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN D BELLAMY CEO 410-728-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2018-02-13 |