| NPI | 1720760069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA L NGUNDAM Vice President 703-623-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |