| NPI | 1053003616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHODA PALMIRA NDAMUKONG Provider 301-532-9242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2024-01-29 |