| NPI | 1003116534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE RENA CARPENTER Case Manger 301-702-6235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD R096203) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2021-05-26 |