| NPI | 1417627530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALISA WARNKE CFO 541-842-7642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2021-09-20 |