| NPI | 1598016545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS KIRBY Administrator 301-651-3980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: VA 0101238065) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: VA 0101238065) |
| 305S00000X Point of Service (Licence: VA 0101238065) | |
| Enumeration Date | 2012-09-29 |
| Last Update Date | 2023-04-17 |