| NPI | 1154699346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT K ROLLETT CFO / COO 317-739-4895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2025-03-28 |