NPI | 1366758088 |
---|---|
Doing Business As | ECC LAKEVIEW CAMPUS |
Entity Type | Organization |
Authorized Contact | CHANDRA SMILEY Executive Director 850-436-4630 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2010-08-19 |
Last Update Date | 2018-11-30 |