| NPI | 1699817775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA BRUTON CEO 866-520-9102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 103T00000X Psychologist |
| 133V00000X Dietitian, Registered | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-11-09 |