| NPI | 1750762126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN S OLSON Chief Executive Officer 302-855-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2020-06-03 |