| NPI | 1245253160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SWANNIE JETT CEO 502-774-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KY 700005) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-11-02 |