NPI | 1962054825 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE WILLIAMS CEO 786-318-2337 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-07-11 |
Last Update Date | 2025-03-09 |