| NPI | 1487764759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOAGLAND C. ELLIOTT Executive Director 317-926-1507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01051367A) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-07-26 |