NPI | 1619232295 |
---|---|
Doing Business As | RVPCS - EASTSIDE FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | JEROME J WHITE Ex. Director 479-431-2057 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2021-08-16 |