NPI | 1306461074 |
---|---|
Doing Business As | STUDENT HEALTH & WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | ALVARO PROSPERO BALLESTEROS Chief Executive Officer 323-201-4516 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2020-06-09 |