| NPI | 1912392358 |
|---|---|
| Doing Business As | JOHNSON ELEMENTARY SCHOOL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | DORA L POTASNIK Credentialing 304-317-7275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-07-25 |