| NPI | 1124579875 |
|---|---|
| Doing Business As | NORTHERN REGION - OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | TAMALA BUTLER Credentialing Specialist 301-883-7822 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2020-09-17 |