| NPI | 1568000248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA ANTIONETTE JACKSON A/R Billing Coordinator 240-671-8902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2025-09-07 |