| NPI | 1831881481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA T GREN VP Performance And Operations, Hcbs 703-578-7195 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |