| NPI | 1366218059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN GARDNER Owner 301-928-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2024-07-10 |