| NPI | 1538980990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA D MITCHELL CEO 219-465-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2024-10-18 |