NPI | 1770886681 |
---|---|
Entity Type | Organization |
Authorized Contact | THERESA A JACKSON Contact 301-816-7405 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MD 03506) |
Enumeration Date | 2010-12-15 |
Last Update Date | 2021-05-27 |