NPI | 1407211824 |
---|---|
Doing Business As | HEALTH CENTER AT SOUTH CIRCLE |
Entity Type | Organization |
Authorized Contact | TRACY NARVET MCMANUS CFO 719-344-6188 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2015-12-30 |
Last Update Date | 2018-09-12 |