| NPI | 1700154978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDELOUAHAB BENMANSOUR Hsa 804-504-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: PA md052885l) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2022-04-22 |