| NPI | 1356061899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI BUSH President And CEO 708-524-7686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2022-09-02 |