| NPI | 1851782163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANUARY LEVERE-WANZER Owner 240-459-8423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD MH-303) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2020-06-04 |