| NPI | 1962234716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA REPAC CFO 301-790-9351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 1041S0200X Social Worker, School | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |