| NPI | 1306896394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENNA J DEEM Executive Assistant 215-302-3150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-08-27 |