NPI | 1326649666 |
---|---|
Entity Type | Organization |
Authorized Contact | ASIM KHAN CFO 218-422-7424 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-11-03 |
Last Update Date | 2023-05-18 |