| NPI | 1720412141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA SWAN Board Chairperson 903-510-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2018-08-17 |