NPI | 1033455209 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY CLOUD CEO 614-274-1455 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2012-12-17 |
Last Update Date | 2022-03-11 |