NPI | 1205080355 |
---|---|
Other Name | PINE STREET INN - WOMEN'S CLINIC |
Entity Type | Organization |
Authorized Contact | AGNES W LEUNG Chief Financial Officer 857-654-1200 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4LQX) |
Enumeration Date | 2008-11-14 |
Last Update Date | 2018-05-29 |