NPI | 1023831450 |
---|---|
Doing Business As | LOCKE WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | ALFREDO REYNOSO Chief Operating Officer 233-313-5588 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2024-11-04 |
Last Update Date | 2024-11-04 |