NPI | 1902159619 |
---|---|
Doing Business As | CARBONDALE FAMILY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | TERESA LACEY Executive Director 570-253-8451 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
Enumeration Date | 2012-10-18 |
Last Update Date | 2023-04-11 |