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 |