| NPI | 1376974527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER C. CIANCONE President Of The Board Of Directors 812-240-6056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2020-06-25 |