| NPI | 1558128421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA LALOR Sr. Director / Delegated Official 629-215-3953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |