NPI | 1275893224 |
---|---|
Doing Business As | GRACEMED MOTHER MARY ANNE CLINIC |
Entity Type | Organization |
Authorized Contact | VENUS LEE CEO 316-866-2064 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2012-05-24 |
Last Update Date | 2022-02-01 |