| NPI | 1316473549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER SMITH SIMMONS Director 240-752-2767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD MH-2306) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2023-08-23 |