| NPI | 1376861013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER DEAN LARSON Chief Executive Officer 240-686-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 461) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2010-05-05 |