| NPI | 1891593778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN IBARRA CEO 424-266-7476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-03-05 |
| Last Update Date | 2025-03-05 |