NPI | 1558609628 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER ISBELL Financial Officer 731-253-6690 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2013-01-24 |
Last Update Date | 2013-01-24 |