| NPI | 1942854021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGETTE RATNAM Owner 240-593-1307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-07-28 |
| Last Update Date | 2019-07-28 |