| NPI | 1356393268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI A SMITH CEO 573-339-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-06-26 |