| NPI | 1639696438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEELAH JOHNSON Manager 240-723-1121 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QP0905X Clinic/Center Public Health, State or Local | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2024-08-13 |