| NPI | 1396149654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MUMA Administrator 301-273-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |