NPI | 1639664303 |
---|---|
Doing Business As | NORTHSIDE FAMILY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | ROBERT B TUCKER CEO 229-468-9166 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2024-11-26 |