| NPI | 1164730271 |
|---|---|
| Doing Business As | SOUTHSIDE ELEMENTARY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | MARY-BETH BRUBECK Vice President Of Finance / CFO 304-525-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2022-03-31 |