| NPI | 1457196412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIS NDE Owner 240-640-1512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-11-08 |