| NPI | 1639183353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA M LALOR Director/Delegated Official 629-215-3953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2021-03-29 |