| NPI | 1538811070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT JOSEPH LOPEZ Chief Executive Officer 202-630-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2024-10-08 |