| NPI | 1023906120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE RENEE DIXON Compliance Officer 301-455-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |