| NPI | 1174950075 |
|---|---|
| Doing Business As | GOOSE ROCK ELEMENTARY SCHOOL BASED CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. STANLEY C.E.O. 606-526-9005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: KY 700188) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: KY 700188) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 700188) | |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2024-06-28 |