| NPI | 1497195036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITT LEWIS Administrator 606-837-2108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: KY 900168) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2018-11-20 |