| NPI | 1376164699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANANN EARLY Director Of Compliance 573-582-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2024-12-12 |