| 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 |