| NPI | 1790270502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT SMITH CEO 580-585-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |