| NPI | 1194002857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES TONG CFO 614-813-0177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: OH H80CS22681-01-00) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2026-01-16 |