| NPI | 1174047658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER M KIRBY CEO 740-355-7102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 251S00000X | |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-11-02 |