| NPI | 1033572789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE ZAPPALLA Director 571-271-7289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC14512) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: MD LC6275) |
| 302R00000X Health Maintenance Organization (Licence: DC CACII1158) | |
| 302R00000X Health Maintenance Organization (Licence: VA 0710102822) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |