| NPI | 1497122535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYSHREE NANDA Director 571-236-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DC 400315904426) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health (Licence: DC 400315904426) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: DC 400315904426) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2018-03-17 |