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 |