| NPI | 1164092979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTA SUE CARTER Financial Controller 941-529-0243 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-06-25 |