| NPI | 1508621772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS TOMBISE EKEMA MOSASO Provider/Owner 301-735-6036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-12-18 |