| NPI | 1720784945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE CAROLE MISSIET FOGOUM Provider 202-459-8904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-01-31 |