| NPI | 1154751733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L HACKETT President 202-651-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: DC AC5000088) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |