| NPI | 1720429194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEELAH JOHNSON Manager 240-733-1121 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2024-08-07 |