| NPI | 1538899422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS SUNDERHAUS Cde 419-221-3072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-02-02 |