| NPI | 1972636165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELMA HENDERSHOTT President CEO 269-427-7937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |