| NPI | 1528826690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTINA FOFANAH CEO 202-304-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-03-12 |
| Last Update Date | 2024-06-12 |