NPI 1205221934

Renewed Behaviioral Health and Wellness

Organisation Exclusive Provider Organization Temple Hills, MD

Practice location

Address: 3914 21st Ave, Temple Hills, MD 20748-4320
Phone: (757) 589-7677

Authorised official

Name: Kimberly a Davis
Title: Ceo
Phone: (757) 589-7677

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence LC5858 (MD)

Other Exclusive Provider Organization providers in Maryland →

Registry record

NPI: 1205221934
Entity type: Organization
NPI issued: 31 Mar 2015
Record last updated: 31 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.