NPI 1336676212

Tabula Rasa Domestic Violence INC

Organisation Case Management Agency Lanham, MD

Practice location

Address: 4325 Forbes Blvd STE C, Lanham, MD 20706-4856
Phone: (240) 217-8442
Mailing address: 13017 Wisteria Dr # 172, Germantown, MD 20874-2621

Authorised official

Name: Ava Ross
Title: Executive Director
Phone: (240) 217-8442

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1336676212
Entity type: Organization
NPI issued: 22 May 2017
Record last updated: 22 May 2017

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.