| NPI | 1063646347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE MARIA BRAGG CEO/Clinical Director 202-561-1423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: DC PRC 416) |
| Additional Taxonomies | 251S00000X (Licence: IN 33003023A) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-05-14 |