| NPI | 1326702788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES STEPHEN LUKAS Owner 301-876-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-08-10 |