| NPI | 1538514344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA CRUSER CFO 317-882-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2024-03-15 |