| NPI | 1114893203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES TONG CFO 614-813-0177 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2026-01-16 |