| NPI | 1619106382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MIRANDA CRAIG Executive Director 610-820-7605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: PA OS015738) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2015-10-13 |