| NPI | 1013690718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO CORREA Chief Executive Officer 219-392-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-04-02 |