NPI | 1023407996 |
---|---|
Doing Business As | EAU CLAIRE DEVELOPMENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | DELGADO CANTAVE CEO 803-733-5969 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
Enumeration Date | 2015-01-15 |
Last Update Date | 2022-02-03 |