| NPI | 1043754872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA DESHIELDS CEO 856-541-6092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |