| NPI | 1649864364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA MORRIS Credentialing Speialist 202-715-6590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |