| NPI | 1477174803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT KEANE Chief Executive Officer 202-715-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-05-29 |