| NPI | 1184351173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY BLANK CEO 217-930-2283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2023-04-13 |