| NPI | 1295365260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MORAD-MCCOY Clinical Director 202-505-1848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2022-10-07 |