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 |