| NPI | 1346715281 |
|---|---|
| Other Name | COMMUNITYCARE AT NORTHEAST HEALTH RESOURCE CENTER |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MIDDLETON Managed Care Contract Manager 512-978-9427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2021-01-06 |