| NPI | 1477657658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BROOKS MILLER Executive Director 417-831-0150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2021-12-02 |