NPI | 1154598282 |
---|---|
Entity Type | Organization |
Authorized Contact | KAREN RENEE JOHNSON Asst Dir Of Patient Accounting 872-588-3062 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2008-05-08 |
Last Update Date | 2021-07-01 |