| NPI | 1265175293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASSANDRA A DICKENS Provider 301-675-6471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |