NPI | 1194404590 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC E LOY CEO 270-858-6655 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2023-07-13 |
Last Update Date | 2023-07-13 |