| NPI | 1902142839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILBUR IAN CORT Program Director 301-891-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD MH-531) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2013-05-03 |