| NPI | 1568234409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY E PAVLICK CFO 301-793-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-10-24 |