| NPI | 1275858979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MENGENHAUSEN CEO 605-772-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2010-04-06 |