| NPI | 1194477844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIATU JOBI CEO 301-937-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-01-26 |