| NPI | 1215696976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA R LONG CFO 417-451-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2025-05-28 |