| NPI | 1700056991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANITA HENSON Office Manager 717-230-3906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2017-08-30 |