| NPI | 1982429700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI MCCORMICK Chief Treatment Officer 606-928-6648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-12-03 |