NPI | 1205553195 |
---|---|
Doing Business As | SIU CENTER FOR HEALTHY AGING AND WELLNESS |
Entity Type | Organization |
Authorized Contact | IRIS WESLEY CEO 217-757-8137 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-10-21 |
Last Update Date | 2022-11-29 |