| NPI | 1194019430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE ELIZABETH REYNOLDS Program Administrator 240-520-6429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2015-11-18 |