| NPI | 1144698549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E HUGHES CFO/COO 920-783-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2015-09-02 |