| NPI | 1053033126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRIYANKA MALHOTRA Credentialing Director 301-377-1836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2024-11-07 |