| NPI | 1942503248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA IRENE JOHNSON CEO 541-512-3151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2019-07-15 |