| NPI | 1659323442 |
|---|---|
| Other Name | MOBILE VAN |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHABABB Interim President/CEO 201-866-2388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2013-05-23 |