| 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 |