| NPI | 1649529678 |
|---|---|
| Doing Business As | JORDAN AT CCIA |
| Entity Type | Organization |
| Authorized Contact | BRIDGETTE WIEFLING President/CEO 585-423-2878 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-07 |