| NPI | 1386218212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHA JACKSON Chief Financial Officer 402-457-1215 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2021-05-15 |