| NPI | 1598376659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUWAPELUMI OLUKOTUN Executive Program Director 571-400-8461 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| 251J00000X Nursing Care | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 251T00000X PACE Provider Organization | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-13 |