NPI | 1780155200 |
---|---|
Doing Business As | CL BRUMBACK PRIMARY CARE CLINIC, MANGONIA PARK |
Entity Type | Organization |
Authorized Contact | DARCY DAVIS CEO 561-804-5885 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2018-12-10 |
Last Update Date | 2023-04-18 |