| NPI | 1750187043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL MALIK FOFANAH Medical Director 240-441-7536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |