| NPI | 1912752767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LIBOW Owner 571-207-5376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |