| NPI | 1356987978 |
|---|---|
| Doing Business As | GRACE SBHC MIDDLESBORO HIGH SCHOOL |
| Entity Type | Organization |
| Authorized Contact | CHAD STEVENS Authorized Official 606-526-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2024-06-28 |