| NPI | 1548737232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATESHIA JACKSON CEO/Nurse Practitioner 202-738-0761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |