| NPI | 1699144402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE A SIMMONS Mr. 240-432-9338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 20930) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: DC LC50079182) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-09-22 |