| NPI | 1629807052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESONIJA SHAVON FULGHAM Director/Owner 202-494-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 251S00000X Community/Behavioral Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-08-01 |