| NPI | 1760239040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH WAGNER CEO 580-338-0072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |