Organization
GOSHEN IGNITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIET NUMFOR LCPC (CEO)
(240) 548-0728
Entity
Organization
Contact information
Practice address
4810 JEFFERSON ST, LANHAM, MD 20706-4204
(240) 548-0728
Mailing address
4810 JEFFERSON ST, LANHAM, MD 20706-4204
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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