NPI | 1194174482 |
---|---|
Doing Business As | GRACEMED CAPITOL FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | VENUS LEE CEO 316-866-2064 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2016-06-07 |
Last Update Date | 2022-02-01 |