| NPI | 1922125574 |
|---|---|
| Former Legal Business Name | SOUTHSIDE HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | CLAUDIO AZZARITI CFO 404-564-7009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2008-06-12 |