| NPI | 1538687231 |
|---|---|
| Doing Business As | FAMILY HEALTH SOURCE |
| Entity Type | Organization |
| Authorized Contact | REBECCA COLLIER Credentialing Specialist 386-202-6025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2021-05-06 |