| NPI | 1780165175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN S. OLSON CEO 302-855-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-08-24 |