| NPI | 1952953978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY OLSUFKA Financial Specialist 308-382-4297 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-10 |