| NPI | 1154866903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO FLORES CEO 319-768-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IA 42157584) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2023-01-25 |