| NPI | 1750920294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACOLE A COLE Owner 240-346-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-01-12 |