| NPI | 1104264225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWN R FISHER Director 571-217-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0701005399) |
| Additional Taxonomies | 251B00000X Case Management (Licence: VA 0701005399) |
| 251B00000X Case Management (Licence: DC PRC14123) | |
| 251S00000X (Licence: DC PRC14123) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2014-01-06 |