| NPI | 1639628605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET DELORES CROCKETT CEO 301-602-7334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X (Licence: MD 20148) | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2018-12-11 |