NPI | 1801630801 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXANDRA LUEVANO Program Director 703-420-8992 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
261QM1300X Clinic/Center Multi-Specialty | |
Enumeration Date | 2024-06-24 |
Last Update Date | 2024-06-24 |