NPI | 1336258540 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK R FREELAND Executive Director 618-874-3120 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2016-07-06 |