| NPI | 1063988673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA WARE CEO 580-925-3286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |