| NPI | 1215487608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MITCHELL CEO 219-465-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IN 26026825A) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2024-02-14 |