| NPI | 1215552062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FULAI DIOM AND STEPHANIE WALINJOM Co Owner / Co Founder 443-213-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 106S00000X Behavior Technician | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2022-03-15 |