| NPI | 1992463897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANINNE BLACKWELL Psychiatric Nurse Practitioner 443-201-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-08 |