| NPI | 1063721512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA REPAC CFO 301-790-9351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2025-09-23 |