NPI | 1205446259 |
---|---|
Doing Business As | GRACE CLINIC HEALTH PROFESSIONAL |
Entity Type | Organization |
Authorized Contact | MELVIN L BURKS President/CEO 812-231-8296 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-08-05 |
Last Update Date | 2023-08-23 |