| NPI | 1386782563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT KEANE Chief Executive Officer 202-715-6562 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-06-24 |