NPI | 1235653080 |
---|---|
Doing Business As | GPHA - ALCORN SCHOOL BASED HEALTH SUITE |
Entity Type | Organization |
Authorized Contact | D. TINA SMITH Provider Enrollment Spec. 215-925-2400 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2017-08-02 |
Last Update Date | 2017-08-02 |