| NPI | 1013361583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN E YOUNG Executive Director 937-548-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |