| NPI | 1265420004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA R. WAGNER CEO 605-223-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-08-22 |