| NPI | 1922520485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY PORTER Owner 301-537-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MD LC2095) |
| Enumeration Date | 2017-07-16 |
| Last Update Date | 2017-07-16 |