| NPI | 1780180331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE DELYSE MOSLEY Owner 301-325-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP52323) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-04-03 |