| NPI | 1871330233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSUNMOLA LAKE Manager 301-263-4890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2024-07-12 |
| Last Update Date | 2024-07-12 |