| NPI | 1841941119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK ALBAUGH Director 301-538-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-05-18 |