NPI | 1083208706 |
---|---|
Entity Type | Organization |
Authorized Contact | MUSTAFA MORRIS Credentialing Specilist 202-715-6590 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-02-23 |
Last Update Date | 2021-02-23 |