| NPI | 1629248919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ROBB Chief Executive Officer 574-772-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2016-10-07 |