NPI | 1093716474 |
---|---|
Doing Business As | PEDIATRIC HEALTH AND WIC CENTER |
Entity Type | Organization |
Authorized Contact | KIMBERLY WYARD Chief Executive Officer 818-898-1388 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2005-08-09 |
Last Update Date | 2022-02-22 |