| NPI | 1053946079 |
|---|---|
| Doing Business As | NHCLVAT BROAD STREET |
| Entity Type | Organization |
| Authorized Contact | PAULA HADDAD Billing 610-820-7605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |