NPI | 1033605613 |
---|---|
Entity Type | Organization |
Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-07-06 |
Last Update Date | 2021-04-09 |