| NPI | 1114726148 |
|---|---|
| Other Name | VENICE FAMILY CLINIC - MOBILE CLINIC #4 |
| Entity Type | Organization |
| Authorized Contact | ANDREA BLACKBIRD Chief Financial Officer 310-664-7941 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-21 |