NPI | 1346748654 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY GATES Revenue Cycle Manager 765-254-2685 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2018-02-01 |
Last Update Date | 2018-02-01 |