| NPI | 1104461805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY ANDERSON CEO 419-522-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-10-29 |