| NPI | 1700435948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY STAWAR CEO 812-206-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |