| NPI | 1619279361 |
|---|---|
| Other Name | IMPACT COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM KENNETH HARMANING Chair Board Of Directors 858-206-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |