| NPI | 1982362489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRAOYA NABOTH ERUANGA CEO 301-357-4794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2023-01-31 |