| NPI | 1114508850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNEMARIE FRANCES CLARKE Corporate Officer 267-784-4021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-04-15 |