NPI | 1629684709 |
---|---|
Doing Business As | SUCCESS STREET-WEST HIGH SCHOOL |
Entity Type | Organization |
Authorized Contact | BETH WHITE Hr Administrator 319-874-3429 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-09-23 |
Last Update Date | 2020-09-23 |