| NPI | 1730609314 |
|---|---|
| Doing Business As | LONE JACK SCHOOL BASED HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. STANLEY C.E.O. 606-526-9005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KS 700188) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-06-28 |