| NPI | 1952739054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY THOMPSON CEO 718-924-2254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |