| NPI | 1952934671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KESEWAH KOROMA Nurse Practitioner 301-978-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-02-20 |