| NPI | 1962178921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA HAUFF CEO 509-454-4143 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |