| NPI | 1750975553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE L PHILLIPS Director Of Billing 541-492-0134 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |