| NPI | 1205363132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY BEAUFORD President 301-877-3721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MD 22228) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: MD 22228) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |