| NPI | 1093932683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA M CHERRY Human Resource Director 762-499-6960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-08-07 |