NPI | 1407026016 |
---|---|
Doing Business As | FAMILY HEALTH SOURCE |
Entity Type | Organization |
Authorized Contact | LAURIE ASBURY CEO 386-624-1054 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2008-03-11 |
Last Update Date | 2021-05-06 |