| NPI | 1316126121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUKE TADESSE Executive Director 301-779-2461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD LC0295) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2020-12-07 |