Take Charge Juvenile Diversion Program, Inc.
NPI #1407284995 in Forestville, Maryland
Provider Information
- NPI Number
- 1407284995
- Entity Type
- Organization
- Organization Name
- Take Charge Juvenile Diversion Program, Inc.
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Oct 22, 2013
- Last Updated
- Nov 27, 2013
Practice Location
- Address
- 7610 PENNSYLVANIA AVE
- Address 2
- SUITE 300
- City
- Forestville
- State
- Maryland
- ZIP Code
- 20747-4701
- Phone
- (301) 420-7395
Authorized Official
- Name
- MR. TERRAH JERROD MUSTAF
- Title
- EXECUTIVE DIRECTOR
- Phone
- (301) 420-7395
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
| Community/Behavioral Health |
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