| NPI | 1205689064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BART IRWIN CEO 502-772-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-04-10 |