| NPI | 1942004262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI TYSON Owner 301-828-5239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-04-03 |