| NPI | 1750263422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN OTIS HARRIS CEO 703-680-7950 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |