| NPI | 1013145473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMENTA COTTRELL Director 301-600-3955 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-11-02 |