| NPI | 1952917049 |
|---|---|
| Doing Business As | SUCCESS STREET - EAST HIGH SCHOOL |
| Entity Type | Organization |
| Authorized Contact | BETH WHITE Hr Administrator 319-874-3000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2020-09-23 |