| NPI | 1790116218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ERIC PITTS Executive Director 740-289-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2020-06-09 |