| NPI | 1285305508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA M MULLINS Clinic Operational Manager 301-373-3065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |