| NPI | 1467091355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIAN JACKSON President 202-860-3713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2025-03-02 |