| NPI | 1831209113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT BREAM Medical Director 215-474-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-06-20 |