| NPI | 1770011314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA SIEBEL CEO 718-234-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7001299R) |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2022-07-21 |