| NPI | 1699216622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARCHIE BELLA CEO/Cmo 844-200-2426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2024-07-05 |