| NPI | 1700321957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN WINSTON Bcba 301-576-5487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD ZZ 103K00000X) |
| Enumeration Date | 2016-12-26 |
| Last Update Date | 2016-12-26 |