| NPI | 1982217154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINA S HIRSCH Owner 443-353-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |