| NPI | 1982614103 |
|---|---|
| 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 | 2006-08-09 |
| Last Update Date | 2011-11-14 |