| NPI | 1114673308 |
|---|---|
| Former Legal Business Name | LIFESPAN BEHAVIORAL HEALTH SERVICES PC |
| Entity Type | Organization |
| Authorized Contact | JOSHUA SUSSAL Md/ CEO 301-982-3437 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2023-10-02 |