NPI | 1699841569 |
---|---|
Doing Business As | CENTROMED SANTA ROSA CLINIC/RYAN WHITE CLINIC |
Doing Business As | CENTROMED SANTA ROSACLINIC/RYRAN WHITE CLINIC |
Entity Type | Organization |
Authorized Contact | CHUCK WALZEL VP/CFO 210-334-3724 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TX HBOCS00758-04-00) |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: TX HBOCS00758-04-00) |
Enumeration Date | 2006-11-24 |
Last Update Date | 2019-10-25 |