| NPI | 1376078105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASRA SALAAD Administrator 703-953-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA HCO-171626) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2017-04-30 |
| Last Update Date | 2022-10-19 |