| NPI | 1578990578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HUGHES Chief Financial Officer 920-783-6633 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2014-09-30 |