| NPI | 1366179806 |
|---|---|
| Doing Business As | LCH-PEDS BEHAVIORAL HEALTH LA |
| Entity Type | Organization |
| Authorized Contact | JOSEPH NIEBERGALL Credentialing Specialist 239-424-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2024-07-24 |