Organization
DISTRICT CLINIC HOLDINGS INC
Active
Other names
C. L. Brumback Primary Care Clinics-Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DARCY DAVIS (CEO)
(561) 804-5885
Entity
Organization
Contact information
Practice address
39200 HOOKER HWY STE 101, BELLE GLADE, FL 33430-5368
(561) 642-1000
Mailing address
1515 N FLAGLER DR STE 101, WEST PALM BEACH, FL 33401-3429
(561) 659-1270
(561) 802-3976
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008037114
—
FL
05
—
008037115
—
FL
Enumeration date
04/14/2015
Last updated
09/21/2021
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