| NPI | 1164949251 |
|---|---|
| Doing Business As | GLEN OAKS SCHOOL BASED CLINIC - UP SATELLITE |
| Doing Business As | UPS ACADEMY SGHC SCHOOL BASED SATELLITE |
| Entity Type | Organization |
| Authorized Contact | MARILYN B ANTWINE Compliance Officer 225-642-9676 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-03-17 |