| NPI | 1497717821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN SUE ABEYTA Executive Director 435-888-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2019-06-21 |