| NPI | 1316720626 |
|---|---|
| Doing Business As | LCH FM COLONIAL |
| Doing Business As | LCH SANCTUARY FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | STEVEN BOREN Credential Specialist 239-424-1479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2023-09-14 |