| NPI | 1821464306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HEMKER Chief Financial Officer 440-240-1655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 204E00000X Oral & Maxillofacial Surgery | |
| 207Q00000X Family Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 213E00000X Podiatrist | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |