| NPI | 1972034643 |
|---|---|
| Doing Business As | HUSTONVILLE ELEMENTARY HEALTHY KIDS CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERIC E LOY CEO 240-864-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KY 700172) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |