| NPI | 1083231872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS SUNDERHAUS CEO 419-221-3072 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-08-27 |