| NPI | 1790157584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CLAY CEO 352-732-6599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2023-02-08 |