NPI | 1811545403 |
---|---|
Doing Business As | PARK DUVALLE AT PLEASURE RIDGE PARK HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | SWANNIE JETT CEO 502-774-4401 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-08-28 |
Last Update Date | 2021-11-02 |