| NPI | 1134642622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONIA LAFFITTE Resident Agent 301-485-5259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DC PRC14938) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2021-10-13 |