NPI | 1699334805 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMANTHA CANNON CEO 641-446-2383 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-06-11 |
Last Update Date | 2022-02-11 |