| NPI | 1689169187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JYL NOKES COO 620-792-5700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2018-06-27 |