| NPI | 1164273504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA TALIA PETERSON CFO 361-886-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2025-04-03 |