| NPI | 1952754582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GREEN CEO 708-596-5177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-06-15 |