| NPI | 1982992608 |
|---|---|
| Doing Business As | THE BROAD STREET CENTER |
| Entity Type | Organization |
| Authorized Contact | PETER PRIZIO Executive Director 804-783-2505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2012-12-04 |