| NPI | 1134893134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENICE FOSTER Owner 309-267-6308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| 261QH0100X Clinic/Center, Health Services | |
| 261QR1300X Clinic/Center, Rural Health | |
| 364SH1100X Clinical Nurse Specialist, Holistic | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2024-01-17 |