NPI | 1801389044 |
---|---|
Doing Business As | CENTROMED INDIAN CREEK CLINIC |
Entity Type | Organization |
Authorized Contact | LAWRENCE C WALZEL VP/CFO 210-334-3724 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-06-12 |
Last Update Date | 2019-01-30 |