NPI | 1750860938 |
---|---|
Entity Type | Organization |
Authorized Contact | MARIE ANDRESS Chief Executive Officer 772-925-8200 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2021-07-21 |