| NPI | 1154151736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED POLLICK Executive Director 937-548-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |