| NPI | 1528625332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RAGNAR NESS CEO 443-731-2971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2024-02-12 |