| NPI | 1457525792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA MOORE CFO 773-702-5821 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2012-09-14 |