| NPI | 1851414965 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | ALVARO JOSE SIMMONS CEO 212-862-0054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: NY 7002113R) |
| Additional Taxonomies | 261Q00000X (Licence: NY 7002113R) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2015-01-15 |