| NPI | 1275220303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MILLER RUSH Director Of Finance 574-534-0088 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-04-25 |