| NPI | 1811718471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE LOGAN Executive Director 765-237-8894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |