| NPI | 1235022377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE WHIMS Clinic Administrator 909-881-4376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |