| NPI | 1023163193 |
|---|---|
| Doing Business As | RVPCS NORTHSIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEROME JOSEPH WHITE Executive Director 479-431-2057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-05-15 |