| NPI | 1043268659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEA LYNN SEAGREN Executive Director 712-213-0109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2009-11-01 |