| NPI | 1821172107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE GADDY Billing Manager 215-685-6843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-06-11 |