| NPI | 1104603232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA ROBERSON Program Assistant 240-462-6947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2024-10-03 |