| NPI | 1215404082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ROSE MCKENNA CEO 270-403-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2025-04-30 |