| NPI | 1013219211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA A JACKSON Human Resources 301-816-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD 10350) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2021-05-26 |