| NPI | 1003622101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NED SCHOENFELD CEO 872-270-0960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 101YP2500X Counselor, Professional | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 103TC0700X Psychologist, Clinical | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2025-07-31 |