| NPI | 1952810640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ALBERT LEE CEO 440-953-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2023-11-26 |