| NPI | 1962633081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J URSO President And CEO 708-383-9786 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |