NPI | 1801687066 |
---|---|
Other Name | CROSSING AT 575 WEST HAY STREET |
Entity Type | Organization |
Authorized Contact | TANYA RENEE ANDRICKS CEO 217-877-6111 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2025-05-15 |
Last Update Date | 2025-05-15 |