| NPI | 1104357805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ELIZABETH NEVERSON Executive Director 301-461-7039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |