| NPI | 1558108209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA MORRIS Credentialing Manager 202-890-9972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2024-07-10 |