| NPI | 1447130679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELINE FOHTUNG Owner 571-762-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-11-02 |