| NPI | 1194516401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL LYNN BLANKENSHIP Billing Credentialing Manager 740-451-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-05-15 |