| NPI | 1598314908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY R NICCOLAI Executive Director 724-632-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2019-09-09 |