NPI | 1376046003 |
---|---|
Entity Type | Organization |
Authorized Contact | EFEMWONKIEKIE WILLIAM IYAMU President/CEO 913-302-1470 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2016-01529) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
261QM1000X Clinic/Center, Migrant Health | |
261QP2300X Clinic/Center, Primary Care | |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2018-03-08 |
Last Update Date | 2019-02-06 |