| NPI | 1568843050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E BRAZIL Executive Director 620-229-0434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2022-11-16 |