| NPI | 1982180535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BUNTING Administrator 443-615-3559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |