NPI | 1851966089 |
---|---|
Doing Business As | NORTHSHORE ST. JOHN COMMUNITY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | DAVID HALL CEO 219-763-8112 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2021-05-20 |
Last Update Date | 2021-05-20 |