| NPI | 1588117147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY REGULA CEO 330-363-3179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2020-04-02 |