| NPI | 1992164966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA GOMEZ CEO 202-420-7005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: DC 64001664) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2017-01-13 |