| NPI | 1124499942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L DAVIS CEO 609-278-5970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2025-09-03 |