| NPI | 1427531532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATESHIA JACKSON Nurse Practitioner 202-617-1552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |