| NPI | 1083009997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY WARREN CEO 260-969-6598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2018-12-17 |