| NPI | 1962069393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE ANN FRANCO CFO 909-464-0520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-06-16 |