| NPI | 1124504378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN G. RANDALL CFO 513-454-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2023-11-03 |