| NPI | 1114309721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JACKSON Owner/Chief Executive Officer 240-461-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD LC4018) |
| Additional Taxonomies | 251S00000X (Licence: DC PRC14352) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |