| NPI | 1194133744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELMA HENDERSHOTT CEO/President 269-427-7937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |