| NPI | 1245513811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MENGENHAUSEN CEO 605-772-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2017-02-06 |