| NPI | 1548390990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WILSON Director 301-670-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LCA461) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-05-12 |