| NPI | 1194049544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYED G HADDAD President 301-460-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2011-02-10 |