| NPI | 1912080060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN AYARS CEO 765-281-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QF0050X Clinic/Center Family Planning, Non-Surgical |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-02-27 |