| NPI | 1184004590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY DAVIS CEO 561-804-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2020-03-10 |