| NPI | 1750621769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J URSO President And CEO 708-383-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2013-02-28 |