| NPI | 1053041293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FELIX Provider 240-484-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-06-11 |
| Last Update Date | 2022-06-11 |