| NPI | 1902980865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L.M. (MIKE) CAUDILL Chief Executive Officer 606-633-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KY 700017) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-10-07 |