| NPI | 1427440882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE JAMISON Clinical Social Worker 240-413-7003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD 20070) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 20070) |
| 273R00000X Psychiatric Unit (Licence: MD 20070) | |
| 305R00000X Preferred Provider Organization (Licence: MD 20070) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MD 20070) | |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2015-02-23 |