NPI | 1043375934 |
---|---|
Doing Business As | IMMANUEL FAMILY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | KANAYO K ODELUGA Owner/Md 219-397-6000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261Q00000X Clinic/Center |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2006-12-22 |
Last Update Date | 2019-06-18 |