NPI | 1417526377 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA RENEE CLABON CEO 314-367-5820 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-06-23 |
Last Update Date | 2021-06-24 |