| NPI | 1114603255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHONNIUSS CHEMWENO Authorized Officer 212-261-6542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 251E00000X Home Health |
| 261QC1800X Clinic/Center Corporate Health | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1000X Clinic/Center Migrant Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QR1300X Clinic/Center Rural Health | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-06-23 |