| NPI | 1891494811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DR. KAYSAN JOHNSON-OWENS Medical Director 443-803-7847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-02-28 |