| NPI | 1265081418 |
|---|---|
| Doing Business As | WYOMING JUNIOR HIGH SCHOOL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | TASHA BLACKMON CEO 616-965-8215 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251S00000X |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2023-08-25 |