| NPI | 1912517426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH YISA Director 346-220-3534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2024-12-17 |