| NPI | 1912662248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN HAYES CFO 330-564-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |