| NPI | 1588554554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BONALEWICZ Credentialing Specialist 724-201-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-07-09 |