| NPI | 1396282208 |
|---|---|
| Doing Business As | FAMILY HEALTH SOURCE |
| Entity Type | Organization |
| Authorized Contact | REBECCA COLLIER Credentialing Coordinator 386-202-6025 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2021-08-10 |