| NPI | 1932801164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN H MAHONEY Member 571-208-2421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-03-21 |