NPI | 1316980709 |
---|---|
Doing Business As | MLK HERITAGE HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | TITO L IZARD President CEO 414-267-2021 |
Organization Subpart ? | No |
Primary Taxonomy | 333600000X Pharmacy (Licence: WI 8681-42) |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2016-04-05 |