| NPI | 1609568922 |
|---|---|
| Other Name | EXECUTIVE BLVD LOCATION |
| Entity Type | Organization |
| Authorized Contact | SUE ATKINSON Administrator 301-530-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2025-11-04 |