Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
261QP2300X | |||
Student Health |
261QS1000X |
| NPI # | 1225488562 |
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| LBN Legal business name | CARVER COMMUNITY CLINIC, LLC | ||||||||
| Authorized official | STEPHEN JONES - (MEDICAL DIRECTOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 06/17/2016 | ||||||||
| Last updated | 06/17/2016 - About 10 years ago | ||||||||
| Identifiers |
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