NPI | 1356777114 |
---|---|
Doing Business As | GRACEMED HEALTHY FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | VENUS LEE CEO 316-866-2064 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2013-09-24 |
Last Update Date | 2022-02-14 |