| NPI | 1871031922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN WOOD CFO 440-953-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2017-02-09 |