| NPI | 1588209142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MILLER RUSH Director Of Finance 574-534-0088 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2020-09-28 |