| NPI | 1174892293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH D BOLEK Assoc Dir Of Contracts 240-401-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 22178) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2025-10-24 |