| NPI | 1609913060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE M BEVERLY Executive Director 574-772-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |