NPI | 1659946937 |
---|---|
Entity Type | Organization |
Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-05-20 |
Last Update Date | 2021-05-20 |