| NPI | 1982152799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES TONG CFO 614-225-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: OH H80CS22681-06-01) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2025-10-19 |