| NPI | 1033166095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MILLER RUSH Director Of Finance 574-534-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IN 01035233B) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-12-31 |