| NPI | 1619717923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE LYNNETTE JONES Chief Operations Manager 301-800-7641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-05-27 |