| NPI | 1912333774 |
|---|---|
| Doing Business As | GRACEMED EVERGREEN FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | VENUS LEE CEO 316-866-2064 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2022-02-14 |