Individual
GODWILL MUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(281) 760-8538
Mailing address
5331 85TH AVE, NEW CARROLLTON, MD 20784-3214
(281) 760-8538
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
999
DC
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/13/2023
Last updated
07/27/2023
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