THIRD STREET COMMUNITY CLINIC INC

Clinic/Center — Mental Health (Including Community Mental Health Center)

Code: 261QM0801X

Clinic/Center — Adult Mental Health

Code: 261QM0850X

Clinic/Center — Adolescent and Children Mental Health

Code: 261QM0855X

Pharmacy — Clinic Pharmacy

Code: 3336C0002X

Clinic/Center — Primary Care

Code: 261QP2300X