| NPI | 1700055639 |
|---|---|
| Other Name | ELM AVENUE COMMUNITY CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANNETTE BALLEW CFO 254-313-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2017-07-28 |