| NPI | 1508811910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI R ESTEP Chief Executive Officer 765-281-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-05-11 |