NPI | 1427717644 |
---|---|
Entity Type | Organization |
Authorized Contact | TONY WEBER Chief Executive Officer 866-682-4842 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-12-15 |
Last Update Date | 2021-12-15 |