NPI | 1275813982 |
---|---|
Doing Business As | LCC CAMPUS HEALTH CLINIC |
Entity Type | Organization |
Authorized Contact | GENE SOBCZAK CEO 719-336-0261 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2011-08-25 |
Last Update Date | 2024-09-04 |