| NPI | 1699644740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY J WARREN President/CEO 765-828-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-11-05 |
| Last Update Date | 2025-11-05 |