| NPI | 1538590781 |
|---|---|
| Doing Business As | FIFTH AVENUE BEHAVIORAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | RICARDO ROMAN CFO 619-906-4603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2024-02-20 |