| NPI | 1609809565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY ARLENE BOROS Clinic Director Owner 708-388-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: 042617005) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-12-09 |