| NPI | 1639835580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTESE CHARLES Owner 240-643-3894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2022-06-21 |