NPI | 1396282299 |
---|---|
Entity Type | Organization |
Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2017-01-30 |
Last Update Date | 2019-01-25 |