| NPI | 1427626837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON GILBERT FONVILLE Executive Director 301-909-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 103K00000X Behavior Analyst | |
| 1041S0200X Social Worker School | |
| 106H00000X Marriage & Family Therapist | |
| 171400000X | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2022-03-07 |