| NPI | 1649733320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SIEBEL CEO 718-234-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |