| NPI | 1154136612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDY GUNN CFO 620-792-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-11 |