| NPI | 1912627605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN BAILEY Director Of PFS And Managed Care 270-887-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-11-14 |