| NPI | 1881311603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE NUSSBAUM CEO 747-228-8229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251E00000X Home Health |
| 251G00000X Hospice Care, Community Based | |
| 251T00000X PACE Provider Organization | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-24 |