| NPI | 1902471295 |
|---|---|
| Doing Business As | MARILLACHEALTH |
| Entity Type | Organization |
| Authorized Contact | LATA RAMACHANDRAN CEO 970-200-1629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |