| NPI | 1558355305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN ANDERSON CFO 712-252-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2024-03-06 |