NPI | 1780921536 |
---|---|
Doing Business As | ELM STREET FAMILY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | RICARDO ROMAN CFO 619-515-2300 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2013-01-14 |
Last Update Date | 2024-02-19 |