| NPI | 1831484922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG A ULMER CEO 814-454-4530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-04-21 |