| NPI | 1730551193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASIM KHAN CEO 703-535-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |