| NPI | 1154084002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN S. OLSON Chief Executive Officer 302-855-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |