| NPI | 1013370196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY GHOLSON Administrative Officer 301-496-4506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: AL 19956) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |