| NPI | 1609543594 |
|---|---|
| Doing Business As | FAMILY HEALTH SOURCE |
| Entity Type | Organization |
| Authorized Contact | REBECCA COLLIER Credentialing/Contracts Admin. 386-202-6025 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2021-08-27 |