| NPI | 1558098871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT JOSEPH LOPEZ Chief Executive Officer 202-630-8178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2024-10-08 |