| NPI | 1295102127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RANDALL CFO 513-454-1564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: OH COA.18022-NP) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2023-11-03 |