| NPI | 1548240302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GREEN CEO 443-873-3554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2015-01-05 |