NPI | 1851000707 |
---|---|
Entity Type | Organization |
Authorized Contact | ANCELLA FOMINYAM Provider 240-350-8854 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-11-18 |
Last Update Date | 2023-10-30 |