NPI | 1619427663 |
---|---|
Doing Business As | GIFFORD HEALTH CENTER AT KINGWOOD |
Entity Type | Organization |
Authorized Contact | DANIEL BENNETT CEO 802-728-2211 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2021-08-03 |