| 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 |