| NPI | 1962166207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEIK AMAT TIJAN FAYE CEO 857-206-4067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X Clinic/Center | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2022-09-15 |