| NPI | 1053069096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY HORN Comptroller 405-632-6688 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-04-15 |