| NPI | 1780634964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO DIAZ Chief Executive Officer 317-957-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-12-16 |