| NPI | 1184154429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUSOLA EDWARDS Program Director 703-682-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 385H00000X Respite Care | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2019-10-03 |