| NPI | 1184739443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER HICKS Qi Coord. 620-792-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2022-04-21 |