| NPI | 1649601154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK SYKES VP Of Finance And Operations 202-407-7747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251B00000X Case Management |
| 261Q00000X Clinic/Center | |
| 261QD0000X Clinic/Center Dental | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2022-11-02 |