| NPI | 1811789696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHALIE BASTIEN-MONTPEIROUS Medical Director 863-983-5453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-05-19 |