| NPI | 1326674144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT THEIS COO 816-474-4920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2020-05-12 |