NPI | 1295569630 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL GREEN Billing Manaager 270-858-6655 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-08-28 |
Last Update Date | 2024-08-28 |