| NPI | 1194003657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ROLLETT CEO 317-680-9553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2025-03-28 |