| NPI | 1609401850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENNADY VINOKUR Administrator 301-330-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-01-05 |