| NPI | 1366906844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHANN ACKLEY CFO 937-840-6617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |