| NPI | 1144819319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARVIN LEWIS CEO 321-268-6836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 103TC0700X Psychologist, Clinical | |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2024-02-08 |