| NPI | 1366409237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY BREAKIE Hhs Dirctor 906-248-8315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-06-20 |