NPI | 1881368504 |
---|---|
Entity Type | Organization |
Authorized Contact | SHERRY HOBACK CEO 813-866-0930 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2021-08-05 |
Last Update Date | 2021-08-05 |