| NPI | 1932849858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LIPPARELLI CEO 984-222-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-04-20 |