| NPI | 1720432610 |
|---|---|
| Other Name | CENTENNIAL HS SBWC |
| Entity Type | Organization |
| Authorized Contact | DONALD MOORE Chief Executive Officer 719-543-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |