NPI | 1821771874 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM CORTES Executive Director 219-703-2585 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
363LW0102X Nurse Practitioner, Women's Health | |
Enumeration Date | 2023-08-08 |
Last Update Date | 2024-08-16 |