| NPI | 1366280992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN JENKINS Owner 240-673-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2025-01-05 |