NPI | 1427175090 |
---|---|
Former Legal Business Name | SOUTHSIDE HEALTHCARE |
Entity Type | Organization |
Authorized Contact | CLAUDIO AZZARITI CFO 404-564-7009 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2007-03-26 |
Last Update Date | 2019-05-22 |