| NPI | 1003240722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO SMALL CEO 202-436-5386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 302F00000X) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |