| NPI | 1255846515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAREVA PAGE CFO 614-572-0877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2023-01-30 |