| NPI | 1942058458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER S CHANG President / CEO 269-965-8866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-09 |