| NPI | 1164409926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE BALLEW CFO 254-313-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2025-02-13 |