| NPI | 1487878328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH SZERKINS CFO 920-940-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2024-08-21 |