| NPI | 1063087021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE C OSUALA Medical Director 301-577-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-05-23 |
| Last Update Date | 2021-05-23 |