NPI | 1992583496 |
---|---|
Entity Type | Organization |
Authorized Contact | KARLA RENEE WRIGHT Credentialing Specialist 773-650-1230 |
Organization Subpart ? | No |
Primary Taxonomy | 174H00000X Health Educator |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-09-18 |
Last Update Date | 2023-09-18 |