NPI | 1922599380 |
---|---|
Doing Business As | PEABODY SCHOOL-BASED CLINIC |
Entity Type | Organization |
Authorized Contact | DAVID ADAMS COO 318-648-0375 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
1041C0700X Social Worker, Clinical | |
207Q00000X Family Medicine | |
Enumeration Date | 2018-05-22 |
Last Update Date | 2019-06-26 |