| NPI | 1023474665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAS TYSION EL Director 301-741-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD du36482) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |