| NPI | 1922258367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY A KURCAB CFO 301-599-2172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 174H00000X Health Educator |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2024-02-29 |