NPI | 1558629634 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY J NAGEL CFO 317-576-1335 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2012-04-26 |
Last Update Date | 2012-04-26 |