| NPI | 1598504805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MERRITT CEO 270-975-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |