| NPI | 1225883366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA DAWN BAIR CEO 937-599-1411 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |