| NPI | 1568525244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY T MORALES C.E.O. 219-738-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: IN 060062141) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2014-04-28 |