NPI | 1447873773 |
---|---|
Doing Business As | STRIDE CHC - JEFFERSON PLAZA FAMILY HEALTH DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | BEN WIEDERHOLT President & CEO 303-761-1977 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-05-21 |
Last Update Date | 2020-05-21 |