| NPI | 1497984579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESUS SOTO CEO 515-348-6646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM1000X Clinic/Center, Migrant Health |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2018-05-02 |