| NPI | 1760013395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINWENDU N EZEORU Provider 301-605-5916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251E00000X Home Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2020-02-02 |
| Last Update Date | 2020-02-02 |