| NPI | 1790823797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT A. KEANE Chief Executive Officer 202-715-6562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DC RX0000113) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-05-13 |