| NPI | 1174525943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SPENCER CREITZ Senior Vice President 620-240-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2024-07-22 |