| NPI | 1457980526 |
|---|---|
| Other Name | VARIETY CARE BAPTIST PORTLAND |
| Entity Type | Organization |
| Authorized Contact | TIM REDDOUT CFO 405-632-6688 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2021-03-31 |