| NPI | 1538748538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH DAVIS Billing Manager 918-426-2442 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2023-08-27 |