| NPI | 1629378864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABILA VIOLET TAZANU Executive Director 301-618-8395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: MD doo55053) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2019-08-13 |