| NPI | 1689186785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RIGGS Director Of Finance 765-288-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |