| NPI | 1578612883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE ANDRESS Chief Executive Officer 772-925-8190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2024-12-10 |