| NPI | 1700466372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA GLEATON Office Manager 202-412-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2021-04-08 |