NPI | 1861081002 |
---|---|
Other Name | KP OPTIMUM CARE |
Entity Type | Organization |
Authorized Contact | KATUMU FRANCES PETTIQUOI CEO 301-641-2284 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2021-01-12 |
Last Update Date | 2021-01-12 |