| NPI | 1124227590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANIE CLEMENT RODRICK Chief Financial Officer 202-464-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center (Licence: DC 52194XXXX650001047) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2021-09-23 |