NPI | 1114417342 |
---|---|
Doing Business As | HAZELWOOD EAST |
Entity Type | Organization |
Authorized Contact | ANGEL RENEE CLABON Chief Executive Officer 314-367-5820 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2018-09-26 |