| NPI | 1386922714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENNA J DEEM Credentialing Manager 215-302-3600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2016-03-29 |