| NPI | 1962079012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDMUNDS Owner 301-421-4241 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TR0400X Psychologist, Rehabilitation | |
| 225C00000X Rehabilitation Counselor | |
| 251S00000X | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2021-06-10 |