| NPI | 1679809818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE H YOUNG Supv. Medicaid Claim Unit 202-715-7803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2009-10-22 |