NPI | 1396297917 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA RENEE ARCHIBALDCLABON Chief Executive Officer 314-367-5820 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-10-31 |
Last Update Date | 2019-02-06 |