NPI | 1699134924 |
---|---|
Entity Type | Organization |
Authorized Contact | ANN CLAUSSEN CEO 863-291-5110 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
Enumeration Date | 2016-02-15 |
Last Update Date | 2023-02-07 |