| NPI | 1649659442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LULA MOULTRIE HEATLEY Owner 240-273-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MD 16665) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-12-09 |