| NPI | 1376736223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY MARTOS Director Of Finance And Personnel 721-632-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2010-07-16 |