| NPI | 1922827831 |
|---|---|
| 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) |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-12-04 |