| NPI | 1003450347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLYMAR HERRERA Hr Generalist/Credentialing COO Rd 203-777-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |