| NPI | 1619529054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODEE J DRENKOW Syst EMS Auditor/Credentialing 402-370-1064 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2020-07-09 |