| NPI | 1609604743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MAYS Revenue Cycle Supervisor 765-254-5347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |