| NPI | 1093469231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVEENA JOHNSON-BOLDEN CEO/Nurse Practitioner 240-301-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2023-05-22 |