| NPI | 1467413906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE E HIVELY Chief Executive Officer 620-342-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KS 0427968) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-02-02 |