| NPI | 1740551787 |
|---|---|
| Other Name | 96 WEST |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SULLIVAN CEO 806-765-2611 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2022-02-07 |