| NPI | 1992269757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA DUBOSE Revenue Cycle Manager 562-338-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2025-11-20 |