NPI | 1063100865 |
---|---|
Doing Business As | RUBY WISE ELEMENTARY SCHOOL BASED CLINIC |
Entity Type | Organization |
Authorized Contact | DAVID ADAMS COO 318-648-0375 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-04-28 |
Last Update Date | 2023-04-28 |