| NPI | 1588537633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH SHANE GREEN Partner 202-769-7742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |