NPI | 1205474681 |
---|---|
Doing Business As | JERICHO ROAD COMMUNITY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | JACKIE ENDRESS Credentialing Specialist 716-348-3000 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-12-16 |
Last Update Date | 2021-08-23 |