| NPI | 1083237457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT A. KEANE Chief Executive Officer 202-715-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |