NPI | 1255820858 |
---|---|
Doing Business As | DR. WILFRED ELLIS BUILDING |
Entity Type | Organization |
Authorized Contact | JANIS L SUNDERHAUS CEO 419-221-3072 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-05-09 |
Last Update Date | 2018-07-05 |