NPI | 1881297091 |
---|---|
Doing Business As | LCH -PEDIATRIC BEHAVIORAL HEALTH |
Entity Type | Organization |
Authorized Contact | JOSEPH NIEBERGALL Credentialing Specialist 239-424-1446 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-11-19 |
Last Update Date | 2020-11-19 |