| NPI | 1659462679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DENISE STUKES Chief Executive Officer 215-844-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: PA 032220) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-09-20 |