| NPI | 1548291222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA M ZAEGEL CEO 260-458-2646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 207Q00000X Family Medicine | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-05-02 |