| NPI | 1104255389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD R BERTRAND CEO 605-356-3317 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2015-05-08 |