NPI | 1184298580 |
---|---|
Doing Business As | HOMEPLACE CLINIC DORTON |
Entity Type | Organization |
Authorized Contact | ROXANN CORDIAL Credentialing Coordinator 606-886-8572 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-05-19 |
Last Update Date | 2022-10-21 |