| NPI | 1629324751 |
|---|---|
| Former Legal Business Name | AZALEA HEALTH |
| Entity Type | Organization |
| Authorized Contact | LAURA M. SPENCER Chief Executive Officer 386-328-0108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2020-02-12 |