| NPI | 1609495381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSYANE M KENGNI C RN P Pmh 240-205-3576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2022-07-11 |