| NPI | 1447597844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM GROVE Billing Manager 641-684-6896 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2020-08-06 |