| NPI | 1942914775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REMONICA RAINEY Controller 703-535-5536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |