| NPI | 1255189213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMEON NOMO Owner/CEO 240-506-6401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-05-07 |
| Last Update Date | 2024-05-28 |