| NPI | 1164726626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KELLOGE ROBINSON Medical Director 904-394-8069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: FL ARNP1071492) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2010-12-27 |