| NPI | 1184350811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MONET WATSON COO 541-492-4550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |