| NPI | 1902269012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY GILBREATH CEO 580-241-5294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-12-08 |