| NPI | 1871259994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUHAMMOD AMJAD AHMAD CEO 260-750-4710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2024-11-19 |