| NPI | 1982102919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA R BROWN Director Of Revenue Cycle 937-734-6821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |