| NPI | 1952692220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN BURGESS Program Manager 240-777-4533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 13259) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |