| NPI | 1659959450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN SCHALLER CFO 920-783-6808 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2021-04-01 |