| NPI | 1093364077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ESTREET CEO 443-873-7193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2023-11-27 |