NPI | 1194191676 |
---|---|
Doing Business As | ROCK CAVE ELEMENTARY SCHOOL WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | DORA L POTASNIK Credentialing Coordinator 304-317-7275 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2024-09-12 |