| NPI | 1972071769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MITCHELL CEO 219-465-9503 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2024-01-12 |