| NPI | 1992590863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKENE AGABU Administrator 443-985-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |