| NPI | 1821552019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA ELAINE ISOM Lcpc 240-812-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-28 |