| NPI | 1124149000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE JACKSON President 301-766-7214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |