| NPI | 1922446384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ROEBACK CEO 573-438-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2025-08-19 |