| NPI | 1174525943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA K POSTAI CEO 888-777-9170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2023-01-16 |