| NPI | 1386876233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMBI MCQUADE JONES President And CEO 765-742-1567 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2022-05-09 |