| NPI | 1386196400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA JACKSON Billing Coordinator/Am 301-586-0900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251S00000X (Licence: MD 2898) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2023-10-03 |