| NPI | 1053750521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE HAYES Owner 301-972-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 905516) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX3109) |
| 101YP2500X Counselor, Professional (Licence: MD LC5475) | |
| 101YP2500X Counselor, Professional (Licence: MD LC4709) | |
| 101YP2500X Counselor, Professional (Licence: MD LC4015) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 12637) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2015-03-27 |