| NPI | 1851385918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEROSE HINKLE CFO 541-256-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2024-10-01 |