| NPI | 1568832277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA JAWORSKI Director Of Finance 715-392-1955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MN R 228856-1) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2020-08-26 |