Organization · NPI-2

La Clinica Latino Community Health Centers

Voluntary or Charitable · Saint Louis, MO

NPI number1871663559
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1871663559
Entity type
Organization (NPI-2)
Legal business name
La Clinica Latino Community Health Centers
Organization subpart
No
Enumeration date
Nov 9, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251V00000X Voluntary or CharitableR1H15MOYes

Other names

  • La Clinica (Doing Business As)

Practice location

3646 Fairview Ave
Saint Louis, MO 63116-4747

Phone 314-664-5565 · Fax 314-773-0709

Mailing address

3646 Fairview Ave
Saint Louis, MO 63116-4747

Phone 314-664-5565 · Fax 314-773-0709

Authorized official

David C. Campbell
Medical Director
3146645565

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