| NPI | 1275165508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN R WHITE CEO 573-663-2313 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2022-06-20 |