| NPI | 1114564358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FULAI DIOM AND STEPHANIE WALINJOM Co Owner / Co Founder 443-213-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171M00000X Case Manager/Care Coordinator | |
| 225C00000X Rehabilitation Counselor | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2022-03-15 |