| NPI | 1356899629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE CRAWFORD CEO 269-349-2641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |