| NPI | 1144690371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAUNYA MOORE CFO 918-295-6107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2019-07-24 |