| NPI | 1134901135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN ARENS CEO 866-682-5539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2024-04-11 |